What is a Therapeutic Use Exemption?
Athletes, like all others, may have illnesses or injuries which require them to take particular medications. If the medication which an athlete needs to treat an illness or medical condition happens to fall under the Prohibited List, the athlete should apply for a Therapeutic Use Exemption (TUE). After the ITU Therapeutic Use Exemption Committee has reviewed the application, the athlete may be given authorization to take the needed medicine.

Which athletes should apply to the ITU for a TUE?
If you are included in the ITU International Registered Testing Pool (RTP), you must apply for a TUE directly from the ITU, unless otherwise indicated. ITU has agreements with some National Anti-Doping Organisations (NADOs) to accept their TUEs. Please contact ITU to determine if your NADO will issue your TUE instead of ITU. The ITU RTP is adjusted every quarter and contains the top 50 men and 50 women in the World Rankings.
If you are not included in the ITU Registered Testing Pool you must request a TUE from your National Anti-Doping Organisation. Your National Triathlon Federation can help you locate your NADO. If your country does not have a NADO, the ITU will consider your TUE application.
If you intend to compete in an elite event listed on the ITU International Calendar, but are not in the ITU Registered Testing Pool, you should send a copy of any TUE provided by your NADO to the ITU. The ITU will review the TUE provided by your NADO. You will be advised only if the ITU does not consider the TUE provided by your NADO as valid under ITU Rules.
Age Group athletes do not need to apply for TUEs from ITU.

Note:
The ITU does not designate a list of International Events for which participants must request a TUE directly from the ITU. The ITU only requires athletes who are included in the International Registered Testing Pool to seek their TUEs from the ITU. Athletes who compete in an international event who are not in the ITU RTP should send any TUEs granted by their NADO to the ITU for review, prior to the international competition in which they intend to compete.

Abbreviated TUEs (ATUE)
From 1 January 2009, Abbreviated TUE application forms are no longer being used by any sporting organisations. If you have an existing ATUE which was completed before 1 January 2009, it remains valid until the earliest of the following dates:
The expiration of the current ATUE
31 December 2009

When your ATUE expires you must follow the guidelines below.
If you need to use Glucocorticosteroids
The type of documentation you must submit for the use of glucocorticosteroids depends on the route of administration (how you administer or take the medication).

1. You must complete a full TUE application if you take Glucocorticosteroids by any of the following systemic routes:
Orally through the mouth, usually in the form of pills
Intravenous injection injected into a vein
Intramuscular injection injected straight into a muscle
Rectally into the rectum usually in the form of a suppository
If you have access to ADAMS, you must submit a full TUE application form through ADAMS. You should seek assistance in this task from your team doctor or treating doctor. You must then print off the form, have it signed by your doctor, attach a full medical file and send it to the ITU.

2. You must complete a Declaration of Use form if you take Glucocorticosteroids by any of the following non-systemic routes:
Inhalation through the mouth via an inhaler or puffer
Intradermal injection into the skin
Epidural injection into the spine
Intra-articular injection into a joint capsule
Periarticular injection around a joint
Peritendinous injection around a tendon

3. You do not need to submit any documentation if you take Glucocorticorsteroids by the following routes:
Dermatological on the skin
Auricular - in or on the ear
Buccal inside the mouth (without swallowing)
Gingival - on the gums
Nasal - inside the nose, either by topical application or nasal spray
Ophthalmic on or in the eye
Perianal on or around the anus
If you need to take Beta 2 Agonists for Asthma
If you take Beta 2 agonists (salbutamol, formoterol, terbutaline or salmeterol) by inhalation for the treatment of asthma, you must submit a TUE for Asthma and a full medical file to confirm the diagnosis of asthma and/or its clinical variants. The medical file should include:
A detailed medical history and clinical review
Lung function test with spirometry
Bronchodilator response
Bronchial provocation tests

To assist your doctor in completing the correct tests, and providing the correct medical information, we suggest that he or she consults the WADA Guidelines on Asthma.
If you have access to ADAMS, your application must be submitted via the TUE for Asthma form in ADAMS.

You must also print off the form, ask your doctor to sign the form, attach the full medical file send it by email, fax of mail to the ITU.
If the TUE for Asthma is completed correctly with valid test results, the ITU TUE Committee may grant an approval for up to 4 years.
If you need to take any other medications
If you wish to apply for the therapeutic use of any other substance or method which is included in the Prohibited List, you must complete a full TUE application form and attach a complete medical file.

To assist your doctor in attaching the correct medical documentation we suggest that you access the WADA website to obtain guidelines on the medical information required to support several common medical conditions.

If you have access to ADAMS, you must complete and submit the TUE application form through ADAMS. You must also print off the form, ask your doctor to sign the form, attach the full medical file send it by email, fax of mail to the ITU.

Submission requirements
All TUE applications and Asthma TUE applications must be submitted in legible French or English. Written medical reports must also be submitted in legible French or English, although results of tests may be in the original language.

All TUE applications must be received by the ITU at least 21 days before medication is commenced.
Applications may be received by the ITU by the following means: